Combination intra-medullary and extra-medullary fracture stabilization with aligning arm

Abstract

A device provides a variety of fracture fixation options should a fracture occur after total hip arthroplasty or total knee arthroplasty, and provides associated methods and apparatus for application of provided fixation. The ability to pre-engineer fracture fixation contingent solutions into femoral or tibial components provides for a distinct clinical advantage in the planning and execution for periprosthetic fracture fixation. Said methods and apparatus include targeting devices which allow for intimate association of fixed angle locking screws in pre-drilled holes in an existing prosthetic, femoral nail, or other components including additional fixation components. Such apparatus and methods further include the use of alignment devices and other components to allow for ease of repair of fractures utilizing the pre-engineered solutions.

What is claimed is: 
     
       1. A fracture fixation apparatus for securing a plurality of bone segments including at least one fracture between the plurality of bone segments, comprising:
 an intramedullary nail; 
 one or more intramedullary nail screws; 
 wherein the intramedullary nail comprises a plurality of intramedullary nail clearance holes for accepting one or more of the intramedullary nail screws; 
 an extramedullary plate; 
 one or more extramedullary plate screws; 
 wherein the extramedullary plate comprises a plurality of extramedullary plate clearance holes for accepting one or more of the extramedullary plate screws; 
 an aligning arm, for mechanically registering the intramedullary nail and the extramedullary plate; 
 wherein the aligning arm comprises one or more first alignment features for providing mechanical alignment of at least one of the intramedullary nail screws with respective ones of the intramedullary nail clearance holes, so as to allow for the insertion of the at least one intramedullary nail screws within the respective ones of the intramedullary nail clearance holes in mechanical registration; and 
 wherein the aligning arm further comprises one or more second alignment features for providing mechanical alignment of at least one of the extramedullary plate screws with respective ones of the extramedullary plate clearance holes, so as to allow for the insertion of the at least one extramedullary plate screws within the respective ones of the extramedullary plate clearance holes in mechanical registration. 
 
     
     
       2. The apparatus of  claim 1  wherein the one or more first alignment features comprise respective one or more cannula. 
     
     
       3. The apparatus of  claim 1  wherein the one or more second alignment features comprise respective one or more cannula. 
     
     
       4. The apparatus of  claim 1  wherein the intramedullary nail is further configured to provide a) access to an intramedullary canal and b) clearance associated with at least one feature of an in situ prothesis. 
     
     
       5. The apparatus of  claim 4  wherein in situ prosthesis is a distal femoral component of a knee arthroplasty. 
     
     
       6. The apparatus of  claim 4  wherein the clearance associated with the at least one feature provides for avoidance of an articulating surface of the in situ prothesis. 
     
     
       7. The apparatus of  claim 1  where at least one of the intramedullary nail screws also serve as at least one of the extramedullary plate screws. 
     
     
       8. The apparatus of  claim 1  wherein one or more additional screws pass through both the extramedullary plate and the intramedullary nail. 
     
     
       9. The apparatus of  claim 1  wherein at least one of the extramedullary plate screws also engages the intramedullary nail. 
     
     
       10. The apparatus of  claim 1  wherein
 the aligning arm further comprises one or more third alignment features for providing mechanical alignment of at least one additional screw with both at least one of the extramedullary plate clearance holes and with at least one of the intramedullary nail clearance holes, so as to allow for insertion of the at least one additional screw within at least one respective extramedullary plate clearance hole and at least one respective intramedullary nail clearance hole in mechanical registration. 
 
     
     
       11. The apparatus of  claim 1  further comprising:
 the intramedullary nail having an intramedullary nail feature; 
 the extramedullary plate having an extramedullary plate feature; and 
 wherein the intramedullary nail feature and the extramedullary plate feature further enable use of the intramedullary nail together with the extramedullary plate.